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Breast screening advice updated amid controversy over harm

View profile for Judith Thomas-Whittingham
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BBC News Health website has stated women who are invited to have breast cancer screening in the UK are to be given more information about the potential harms of being tested.

An independent review has been set up to settle the debate about whether the screening measures have done more harm than good.

It has demonstrated that for every life saved, three women had treatment for a cancer which would never have been fatal.

The government has said leaflets will be provided offering information to women enabling them to make an informed choice.  Leaflets on breast cancer screening will be sent directly to women, and will be updated in the “next few months”.

Screening to diagnose breast cancer has been in place for more than 20 years.  Women between the ages of 50 and 70 are invited to attend for a mammogram every three years.  The intention is this will assist doctors in diagnosing cancer at an early stage, so that treatment may be offered when it is more likely to save lives.

Prof Sir Mike Richards, the national cancer director, has said that this had become “an area of high controversy.”

The concept of “overdiagnosis”, ie screening which correctly identifies a tumour, but one which would never have caused harm, is an area of some controversy.  Women who may subsequently have lived full and healthy lives are having treatments such as surgery and chemotherapy – which have considerable potential risks and side-effects.

A review published in the leading medical journal the Lancet showed that screening saved 1,307 lives every year in the UK, but led to 3,791 women having unnecessary treatment.  There is a 1% chance of being overdiagnosed, if they attend screening, from the point of view of a single patient.

The independent review panel was led by Prof Michael Marmot from University College London.  Prof Marmot alleges screening had “contributed to reducing deaths” but had also “resulted in some overdiagnosis”.

A joint statement by Breakthrough Breast Cancer, Breast Cancer Campaign and Breast Cancer Care said “we encourage all women to attend their screening appointments”.

Research is advancing, and it is hoped that in the future there will be a number of new techniques that can be used alongside the present screening programme in order to make it more efficient.
 

By medical professional, Karen Andrews

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